Care coordination is a multilevel concept that incorporates a wide range of activities. The term often means different things to different people. The term care coordination may be used interchangeably with terms such as case management, disease management, and care management. We use the term of care coordination broadly as a set of tools available for improving the delivery of coordinated care, which could include disease management, case management, and transitional care. Because care coordination has been adopted as a strategy to improve quality of care, enhance the patient experience, and save costs, care coordination efforts are generally focused on people who have or who are going to have significant contact with the health care system (Hackbarth & Berenson, 2012).
Internal Models of Care Coordination
- Medical Practice: Patient-Centered Medical Home
- Hospital to Home: Transitional Care Model, Care Transitions Intervention
- Single Organization: Hospital-embedded or clinic-embedded care coordinators/care managers/discharge planners/ social workers/case managers
External Models of Care Coordination
- Inter-Organizational: Accountable Care Organization (ACOs), Community Health Team, Community Care Team
Hackbarth, G. M., & Berenson, R. (2012). Report to the Congress: Medicare and the health care delivery system. Washington, D.C.: Medicare Payment Advisory Commission Retrieved from http://www.medpac.gov/documents/Jun12_EntireReport.pdf.